Newswise — Medical experts in Australasia have expressed worry over the increasing prevalence of severe acute pancreatitis (SAP) in ICUs, as mortality rates in these critically ill individuals have remained unchanged for nearly 20 years.
Given the lack of a definitive cure for acute pancreatitis, the collaborative study between Flinders University and the Australian and New Zealand Intensive Care Society (ANZICS) emphasizes the need for focused clinical research to identify treatments that can effectively minimize extended hospital stays and reduce mortality rates. This research is particularly crucial as the prevalence of this disease continues to rise.
In certain regions, the severe variant of this condition results in fatalities in as many as 40% of instances. Over the past six decades, high-income countries have observed a steady increase in the occurrence of acute pancreatitis, accompanied by mortality rates ranging from 6.9 to 11.7 million individuals annually.
According to a study conducted in 2022 by the Dutch Pancreatitis Study Group, only two out of three individuals (67%) diagnosed with severe acute pancreatitis (SAP) requiring ICU admission will survive within one year.
According to Professor David Pilcher, who heads the ANZICS Centre for Outcome and Resources Evaluation at Monash University, although patients with severe acute pancreatitis (SAP) in Australian and Aotearoa New Zealand ICUs have relatively low mortality rates compared to global standards (12% in hospitals and 8% in ICUs), the fact that these rates have not changed indicates the importance of exploring strategies to enhance these outcomes.
The recently conducted study examined clinical data from the ANZICS database, encompassing a total of 12,635 adult patients diagnosed with severe acute pancreatitis (SAP). The analysis focused on three consecutive six-year periods, spanning from 2003 to 2020.
The study did not observe any significant differences in adjusted hospital mortality and ICU mortality rates across the three time periods analyzed. However, there was a slight reduction in the median length of hospital admission, with durations decreasing from 13.9 days in 2003-08 to 13.1 days in 2009-14 and further to 12.5 days in 2015-20. No significant variation was noted in the length of ICU stay, and the cost of managing severe acute pancreatitis (SAP) in Australian and New Zealand ICUs remained constant throughout the three time periods.
Associate Professor S. George Barreto, a surgeon at Flinders Medical Centre and the lead author of the study, emphasizes the importance of directing efforts towards the development of strategies that can accurately predict the severity of the disease upon admission. Additionally, the study underscores the need for research aimed at identifying effective treatments that can halt the progression of the disease from a mild form to the severe variant, which is characterized by sustained organ failure.
According to Associate Professor S. George Barreto, the study's findings suggest that the comparatively better mortality rates could be linked to the strategy of transferring patients with severe acute pancreatitis (SAP) and organ failure to the ICU, where their organ failure can be efficiently treated. Lowering the threshold for such transfers seems to have a beneficial effect on patient outcomes.
Associate Professor Barreto shared the research outcomes during the Annual Scientific Congress of the Royal Australasian College of Surgeons. The study encompassed data from 98% of Australian ICUs and 67% of ICUs in Aotearoa New Zealand.
The research article titled "Mortality and costs associated with severe acute pancreatitis in the intensive care units of Australia and New Zealand (2023)" authored by Savio George Barreto, Billingsley Kaambwa, Karthik Venkatesh, Sarah C Sasson, Christopher Andersen, Anthony Delaney, Shailesh Bihari, David Pilcher, and the P-ANZICS Collaborative has been recently published in the journal Pancreatology (Elsevier). The article can be accessed using the DOI: 10.1016/j.pan.2023.04.006.
Associate Professor Barreto, who is based at the Hepatopancreatobiliary and Liver Transplant Unit at Flinders Medical Centre, has recently published research relating to developments in young on-set cancers and pancreatic cancer.
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